Purpose for the program: A lack of communication was identified surrounding a mother‘s feeding decision and multiple health care providers.  This lack of communication resulted in a mother's perceived lack of respect by providers regarding the mother’s preference for newborn feeding.  To address this issue, an innovative, cribside, infant feeding plan documentation tool was created to identify a mother’s feeding preference for her newborn from birth through discharge. Providers also noted a large variation between provider practices related to newborn feeding and maternal preference.

 Proposed change: To improve communication between providers and mothers, a cribside infant feeding plan documentation tool was implemented.

Implementation, outcomes and evaluation: Prior to implementation, representatives from each provider groups involved in newborn care collaborated on the creation of the infant feeding plan document.  The development of the individualized plan began at maternal admission, with the use of a scripted narrative, to discuss maternal newborn feeding preferences.  Once feeding preferences were identified, a mutually agreed upon feeding plan was created and signed by both the mother and the nurse.  Throughout the infant’s stay, the plan is located at the infant’s crib. If any changes to the feeding plan are needed, both the nurse and mother discuss, update, and sign the adapted feeding plan. Outcomes and evaluation are on-going. Prior to the implementation of the feeding plan, breastfeeding rates were 68% and during the year post implementation breastfeeding rates have continued to increase to 74%.  Anecdotally, patients report feeling that their infant feeding choice is respected and that the use of this plan prompts infant feeding discussions. Providers commented that the plan is convenient and useful in practice, and the JCAHO recognized it as a Best Practice Model of Care.

Implications for nursing practice: This initiative provided an opportunity for nursing to reenergize their commitments to patient communication and infant feeding, especially breastfeeding.  Patient-Family centered care is based on respect and honest communication between providers and families.  This tool gave nurses an opportunity to dialogue with the infant’s mothers regarding feeding options and changes in infant feeding as needed.  At admission, nurses were able to review with the family the evidence associated with optimal infant feeding.  Also, the tool served as a contract between the mother and the providers to insure that the mother’s feeding preference plan was implemented.  The tool also served as an easy way to communicate to any provider caring for the infant.   

Keywords: Breastfeeding, Infant Feeding Plan, Patient Family Centered Care